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Section 1 - Duties of Office - Section 1. The executive office for health and human services...
Section 2 - Established Authority - Section 2. All powers and duties established pursuant to this...
Section 2a - Director of Dental Services - Section 2A. (a) In order to improve, promote and protect...
Section 6 - Medical Care Advisory Committee; Member; Staff; Report From Office of Medicaid - Section 6. There shall be a medical care advisory committee...
Section 7 - Powers - Section 7. In addition to all powers conferred on state...
Section 8 - Definitions - Section 8. As used in this chapter the following terms...
Section 8a - Definitions for Secs. 13c to 13k and Secs. 64 to 70 - Section 8A. For the purposes of sections 13C to 13K,...
Section 9 - Eligibility - Section 9. There is hereby established, pursuant to and in...
Section 9a - Masshealth; Beneficiaries; Eligibility; Payment; Information Applications - Section 9A. (1) As used in this section and in...
Section 9c - Medical Insurance Reimbursement Programs; Definitions; Eligibility; Expenditures; Submission of Plans - [Text of section effective as provided by 1997, 47, Sec....
Section 9d - Senior Care Options Initiative; Senior Care Organizations; Enrollment Choices; Advisory Committee; Report - Section 9D. (a) As used in this section, the following...
Section 9e - Application for Authority; Implementation of Measures; Waiver of Measures Due to Hardship - Section 9E. The secretary of health and human services may...
Section 9f - Duals Demonstration; Review of Request for Financial Solvency - [Text of section added by 2012, 118, Sec. 25. See...
Section 10 - Medical Care Assistance Program for Pregnant Women and Infants - Section 10. The division shall establish a program of medical...
Section 10a - Required Coverage for Prenatal Care, Childbirth and Postpartum Care - Section 10A. The division shall provide coverage for prenatal care,...
Section 10b - Required Coverage for Newborn Hearing Screening Tests - Section 10B. The division shall provide coverage for the cost...
Section 10c - Required Coverage for Items Medically Necessary for the Diagnosis or Treatment of Diabetes - Section 10C. The division shall provide coverage for the following...
Section 10d - Required Coverage for Treatment of Breast and Cervical Cancer - Section 10D. The division shall, within the limits of the...
Section 10e - Healthy Start Program; Medical Assistance for Pregnant Women and Infants; Eligibility; Types of Assistance; Protection From Billing and Collection Practices - Section 10E. The division shall establish a program of medical...
Section 10f - Health Care Services for Dependent and Adopted Youths; Funding; Types of Services; Eligibility; Program Reports; No Entitlement - Section 10F. (a) There is hereby established a program of...
Section 10g - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate - [Text of section applicable as provided by 2012, 234, Sec....
Section 10h - Coverage for Medically Necessary Treatments for Persons Younger Than 21 Years Old Diagnosed With an Autism Spectrum Disorder by a Licensed Physician or a Licensed Psychologist - [Text of section added by 2014, 226, Sec. 25. See...
Section 10i - Coverage for Administration of All Federal Food and Drug Administration Approved Drugs for Opioid or Alcohol Dependence Treatment - Section 10I. The division and its contracted health insurers, health...
Section 10j - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome - Section 10J. The division shall provide coverage for medical or...
Section 10k - Coverage for Certain Services and Contraceptive Methods - Section 10K. (a) The division and its contracted health insurers,...
Section 10l - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity - Section 10L. The division and its contracted health insurers, health...
Section 10m - Coverage for Tobacco Use Cessation Counseling and Products - [Text of section applicable to policies, contracts and subscription certificates...
Section 10n - Urgent Care Facilities; Referrals; Primary Care Providers - Section 10N. (a) For the purposes of this section, the...
Section 11 - Cooperation With Federal Authorities - Section 11. The division shall, within the limits of the...
Section 12 - Policies; Procedures; Rules and Regulations; Contracts - Section 12. In administering the medical assistance programs established under...
Section 12a - Pharmaceutical Drugs; Negotiation of Supplemental Rebate Agreements - Section 12A. (a) As used in this section, the following...
Section 13 - Rate Changes; Review - Section 13. The commissioner shall review, and approve or disapprove,...
Section 13a - Non-Acute Hospitals; Rates and Terms of Payment - Section 13A. For hospital fiscal years beginning on or after...
Section 13b - Hospital Rate Increases; Quality Standards and Benchmarks - Section 13B. Hospital rate increases shall be made contingent upon...
Section 13c - Establishment of Rates of Payment for Health Care Services - Section 13C. The secretary of the executive office shall establish...
Section 13d - Duties of Ratemaking Authority; Criteria for Establishing Rates - Section 13D. The executive office, or a governmental unit designated...
Section 13e - Appeals of Interim or Final Rates - Section 13E. Except for rates established under section 13F, any...
Section 13e1/2 - Contractual Arrangements With Acute and Non-Acute Hospitals - Section 13E1/2. All purchasers and third party payers, excluding purchasers...
Section 13f - Contracts Between Acute and Non-Acute Hospital Service Providers and Office of Medicaid - Section 13F. All rates of payment to acute hospitals and...
Section 13g - Hospital Assets Not to Be Considered as Resources for Purpose of Establishing Rates - Section 13G. The executive office, or a governmental unit designated...
Section 13h - Recipients of Benefits Under Chapter 117a - Section 13H. No acute hospital shall deny access to care...
Section 13i - Patients With Foreign Residency - Section 13I. Notwithstanding any provisions of this chapter to the...
Section 13j - Health Maintenance Organizations; Contracting Rights - Section 13J. A health maintenance organization organized under chapter 176G...
Section 13k - Adjustment of Facility's Rate - Section 13K. Upon petition of a receiver appointed under section...
Section 13l - Restriction of Hospital Access to Discounted Purchase of Prescription Drugs - Section 13L. The secretary of health and human services, hereinafter...
Section 14 - Nursing Home Negotiated Rate Contracts - Section 14. Pursuant to the second paragraph of section twelve,...
Section 14a - Reimbursement to Nursing Homes for Admissions to Acute Care and Chronic Disease or Rehabilitation Hospitals - Section 14A. The division shall treat admissions to acute care...
Section 15 - Medicaid Benefits; Rules and Regulations; Managed Care; Personal Expenses - Section 15. The division shall provide Medicaid benefits for such...
Section 16 - Primary and Supplemental Medical Care and Assistance Program for Disabled Residents; Assistance Program for Chronically Ill or Disabled Persons Forced to Leave Employment or Substantially Reduce Work Hours - Section 16. The division shall establish a program of primary...
Section 16a - Medical Care and Assistance Program for Disabled Children - Section 16A. The division shall establish a program of medical...
Section 16a1/2 - Costs Incurred for Medical Programs Projected to Exceed Available Appropriations; Notice - Section 16A1/2. The commissioner shall notify the house and senate...
Section 16c - Child Health Insurance Program; Medical Benefits; Costs; Eligibility - Section 16C. (1) There is hereby established the child health...
Section 16d - Aliens or Persons Residing in United States Under Color of Law; Benefits - Section 16D. (1) Eligibility for benefits for aliens pursuant to...
Section 17 - Reimbursements for Non-Generic Drugs - Section 17. Multiple source drugs listed in the Massachusetts list...
Section 17a - Emergency Services Provided to Beneficiaries for Emergency Medical Conditions - Section 17A. (a) As used in this section, the following...
Section 18 - Medical Insurance Purchases for Persons Eligible for Assistance - Section 18. The division may purchase on behalf of any...
Section 19 - Prior Approval of Medical Services; Methods; Rules and Regulations; Posttreatment Examinations - Section 19. The division shall establish methods of approving services...
Section 20 - Application; Forms; Application by Institution - Section 20. An application or reapplication by an individual for...
Section 21 - Inquiry by Department; Notification of Applicant; Agreement - Section 21. Upon receipt of such application, the division shall...
Section 21a - Medical Assistance Eligibility of an Institutionalized Spouse - Section 21A. (a) In determining the eligibility for medical assistance...
Section 22 - Third Party Payments; Repayment; Assignment; Subrogation - Section 22. (a) As used in this section, the following...
Section 23 - Subrogation Rights; Health Insurance Benefits; Garnishment of Wages - Section 23. As used in this section, health care insurer,...
Section 23a - Financial Institutions; Request for Deposit and Withdrawal Records; Penalty - Section 23A. Upon written request signed by an authorized employee...
Section 25 - Exempt Income and Resources - Section 25. For purposes of determining an individual's eligibility for...
Section 25a - Determination of Eligibility for Qualified Medicare Beneficiary, Specified Low-Income Medicare Beneficiary and Qualified Individual Programs; Consideration of Certain Income or Assets - Section 25A. (a) For individuals 65 years of age or...
Section 26 - Identification Card - Section 26. The division shall issue a numbered identification card...
Section 27 - Redetermination of Eligibility - Section 27. If an individual has become eligible under this...
Section 28 - Disposal of Resources at Less Than Fair Market Value; Period of Ineligibility - Section 28. In determining the eligibility of an institutionalized individual,...
Section 29 - Transfer of Interest in Real Property; Notice - Section 29. Whenever an individual who is receiving medical assistance...
Section 30 - Time of Payment - Section 30. When the division determines that an applicant is...
Section 31 - Adjustment or Recovery of Payments - Section 31. (a) This subsection shall apply to estates of...
Section 32 - Provision of Death Certificate and Probate Petition to Division; Liability of Estate Beneficiaries; Claims Against Estate; Sale or Transfer of Property Subject to Lien or Claim - Section 32. (a) Notwithstanding any provision of law to the...
Section 33 - Long Term Care Insurance Purchasers; Liability for Medical Assistance Paid - Section 33. No claim for costs of a nursing facility...
Section 34 - Liens and Encumbrances - Section 34. No lien or encumbrance of any kind except...
Section 35 - Reimbursement for Covered Claims; Submission of Information - Section 35. No claim for medical care or services provided...
Section 36 - Eligible Providers; Responsibility for Overpayments - Section 36. Participation in the medical assistance programs established under...
Section 37 - Distribution of Rules, Regulations to Providers; Administrative Sanctions - Section 37. The division shall distribute to all providers a...
Section 38 - Submission of Bills by Providers; Appeals for Erroneous Denials; Overpayments; Civil Collection Actions - Section 38. Providers shall submit to the division a bill...
Section 38a - Retroactive Claims Denials for Behavioral Health Services - Section 38A. (a) For the purposes of this section, the...
Section 39 - False Representations, Failure to Disclose; Penalty - Section 39. Any person or institution which knowingly makes a...
Section 40 - False Statements or Representations by Providers; Penalty - Section 40. Any person who furnishes items or services for...
Section 41 - Bribery or Rebates; Penalty - Section 41. Whoever solicits or receives any remuneration, including any...
Section 42 - Excess Charges; Penalty - Section 42. Whoever knowingly and willfully charges for any service...
Section 43 - Health Care Facilities; Additional Charges as Precondition for Admission or Continuance; Penalty - Section 43. Whoever knowingly and willfully charges, solicits, accepts or...
Section 44 - Civil Remedies; Limitations - Section 44. If any person violates the provisions of this...
Section 45 - Venue; Actions Relating to False Claims - Section 45. Any action brought under this chapter may be...
Section 46 - Availability of Other Remedies - Section 46. The remedies in sections thirty-nine to forty-five, inclusive,...
Section 46a - Providers; Submission of Claims for Payment Not in Compliance With Policies and Procedures of Medical Assistance Program; Proof of Clerical or Administrative Error - Section 46A. Any provider making a claim for payment under...
Section 47 - Persons Aggrieved; Right to Hearing; Investigation; Decision; Rehearing; Notice - Section 47. Any applicant for or recipient of medical assistance,...
Section 47a - Benefits Available Only to Otherwise Eligible Individuals Showing Lawful Presence in the United States or Meeting Applicable Federal Requirements Necessary to Qualify for Benefits for Which the Commonwealth Receives Federal Reimbursemen... - Section 47A. Benefits for individuals age 19 or older for...
Section 48 - Board of Hearings - Section 48. There shall be within the division a board...
Section 49 - Use and Disclosure of Information - Section 49. The use or disclosure of information concerning applicants...
Section 50 - Contract for Administrative Functions; Underwriting of Program - Section 50. To the extent feasible the division may contract...
Section 51 - Utilization Review of Care and Services; Data Processing and Collection Procedures; Liability in Civil Actions - Section 51. The division, in cooperation with the department of...
Section 52 - Maintenance of Standards for Providers; Development of New Programs - Section 52. The division, in cooperation with the department of...
Section 53 - Covered Services - Section 53. The division shall include within its covered services...
Section 54 - Wellness Program for Masshealth Enrollees - Section 54. The executive office of health and human services...
Section 56 - Controlled Substance Management Program for Masshealth Enrollees - Section 56. The division shall establish a controlled substance management...
Section 61 - Availability of Benefits to Persons Recognized as a Spouse Under Laws of the Commonwealth - Section 61. Notwithstanding the unavailability of federal financial participation, no...
Section 62 - Acceptance and Recognition of Information Submitted Pursuant to Coding Standards and Guidelines Required; Use of Standardized Claim Formats - Section 62. (a) Subject to subsection (c), for the purposes...
Section 63 - Assessment per Non-Medicare Reimbursed Patient Day - Section 63. (a) For the purposes of this section, the...
Section 64 - Definitions for Secs. 64 Through 69 - Section 64. As used in sections 64 to 69, inclusive,...
Section 65 - Health Safety Net Office - Section 65. (a) There shall be established within the office...
Section 66 - Health Safety Net Trust Fund - Section 66. (a) There shall be established and set up...
Section 67 - Liability of Acute Hospital to Fund - Section 67. (a) An acute hospital's liability to the fund...
Section 67a - Nonpublic Ambulance Services; Liability; Uniform Assessment; Enforcement - Section 67A. (a) The following words shall, unless the context...
Section 68 - Surcharge Assessed by Acute Hospitals and Ambulatory Surgical Centers - Section 68. (a) Acute hospitals and ambulatory surgical centers shall...
Section 69 - Reimbursements to Hospitals and Community Health Centers for Health Services Provided to Uninsured and Underinsured Individuals - Section 69. (a) Reimbursements from the fund to hospitals and...
Section 70 - Definitions for Secs. 70 Through 75 - Section 70. As used in sections 70 to 75 inclusive,...
Section 71 - Pca Quality Home Care Workforce Council - Section 71. (a) There shall be a PCA quality home...
Section 72 - Duties of Workforce Council; Pca Recruitment, Training and Referral Resources; Lists of Pcas - Section 72. (a) The workforce council shall carry out the...
Section 73 - Rights of Consumers Regarding Pcas; Public Employee Status for Limited Purposes; Collective Bargaining - Section 73. (a) Consumers or the consumer's surrogate shall retain...
Section 74 - Pca Quality Home Care Workforce Council; Scope of Power and Authority - Section 74. (a) The PCA quality home care workforce council...
Section 75 - Performance Reviews - Section 75. (a) The council shall conduct a performance review...
Section 76 - Designation of Another Governmental Unit to Perform Functions Set Forth in Secs. 13c Through 13k and 64 Through 75 - Section 76. The secretary of the executive office may designate...
Section 77 - Office of Medicaid to Attribute Members to Primary Care Providers - Section 77. To the maximum extent possible, the office of...
Section 78 - Employer Healthcare Coverage Form - Section 78. (a) The division shall create an employer healthcare...
Section 79 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider; Right in In-Person Services; Copayment or Coinsurance; Rate of Payment; Standards of Care - Section 79. (a) For the purposes of this section, the...